Orthopedic device for combination with a plaster cast

ABSTRACT

The device is intended for combination with a plaster cast of the type which is applied to the foot of a fracture patient and leaving the toes uncovered. The device comprises a U-shaped member adapted to be attached at the ends thereof to the opposite sides of a plaster cast and extending around the front of the cast to protect the patient&#39;&#39;s toes, and to serve as a toe traction splint when required.

United States Patent [1 1 Cappelletti [451 Sept. 3, 1974 ORTHOPEDIC DEVICE FOR COMBINATION WITH A PLASTER CAST [75] Inventor: Richard R. Cappelletti, Kinderhook,

NY [73] Assignee: Lambda Development Ltd., Albany,

[22] Filed: Aug. 30, 1972 21 Appl. No.: 234,957

OTHER PUBLICATIONS Granberry Foot Splint, De Puy Fracture Appliances Catalogue, 1944, page 71.

Banjo Splint, Zimmer Catalogue, page 90, 1947.

Primary Examiner-Richard A. Gaudet Assistant Examiner-J. Yasko Attorney, Agent, or FirmCurtis Ailes 57 ABSTRACT:

The device is intended for combination with a plaster cast of the type which is applied to the foot of a fracture patient and leaving the toes uncovered. The device comprises a U-shaped member adapted to be attached at the ends thereof to the opposite sides of a plaster cast and extending around the front of the cast to protect the patients toes, and to serve as a toe traction splint when required.

21 Claims, 10 Drawing Figures PATENTED SEP 31974 SHEET 10f 3 FIG. 2

PATENTED 31974 SHEET 2 0F 3 PATENTEB SEP 3 sun so; s

FIG. 8

FIG. 7

FIG. 9

ORTHOPEDIC DEVICE FOR COMBINATION WITH A PLASTER CAST This invention relates to an orthopedic device for combination with a plaster cast on the foot for protecting the toes of the wearer of the plaster cast.

For fractures of the foot, ankle, or leg, it is the usual procedure to apply a plaster cast which covers the foot to thereby immobilize the foot. It is customary to leave the cast open at the toes so that the toes can be flexed and exercised, thereby facilitating healing by improving blood circulation. This practice leaves the toes exposed and vulnerable to accidental injury. For example, ambulatory patients, and particularly young active children, often bump their exposed toes on floors, walls, and furniture legs. Furthermore, bed clothing exerts uncomfortable pressure on the toes which cannot be avoided since the foot cannot be rotated. This problem is sometimes dealt with by constructing the cast with a plaster extension built out beneath the toes. However, this solution is not satisfactory because itis expensive and time consuming to construct, it is fragile and liable to be broken, and it often prevents downward flexion of the toes, thereby limiting the extent of toe exercise.

It is an object of the invention to provide an improved protective device for the toes for incorporation with a plaster cast applied to the foot.

Another problem with foot fracture patients is that there are often broken toes, or broken bones in the foot, or both, which require that one or more toes mu be placed in traction for proper healing.

Accordingly, it is another object of the invention to provide a device for combination with a plaster cast for the foot of the fracture patient which constitutes in combination a toe guard for guarding the toes of the patient, and an improved traction splint for holding one or more toes of the patient in traction.

Other objects and advantages of the invention will be apparent from the following description and the accompanying drawings.

In carrying out the invention there is provided an orthopedic device for combination with a plaster cast of the type applied to the foot of a fracture patient and leaving the toes uncovered, said orthopedic device comprising a substantially U-shaped member of semirigid material having a spacing between the ends thereof generally corresponding to the width of a typical human foot, said member being adapted to be attached at the ends thereof tothe opposite sides of the plaster cast and extending around the front of the cast to protect the patients toes, said member including surface discontinuities longitudinally spaced along each end thereof to provide for anchorage of said ends within the plaster cast.

In the accompanying drawings:

FIG. I is a top view of a preferred'embodiment of the invention. I I

FIG. 2 is a side view of the embodiment of FIG. 1.

FIG. 3 is a perspective view illustrating the invention in combination with a foot cast and functioning as a toe guard.

FIG. 4 is a perspective'view of the device of the invention in combination with a foot cast and functioning as a combined toe guard'and toe traction splint.

FIG. 5 is a side detail view illustrating a modification of the structure of the end of the device of FIGS. 1 and 2.

FIG. 6 is a partial detail view illustrating a modification of the mid-section of the device of FIG. I employing edge slots for the attachment of the toe traction apparatus.

FIG. 7 is a partial detail view illustrating a modification of the mid-section of the device of FIG. I employing edge slots in opposite edges for the purpose of attaching the toe traction apparatus.

FIG. 8 is a partial detail view illustrating a modification of the mid-section of the device of FIG. I employing through holes for attachment of the toe traction apparatus. FIG. 9 is a partial detail view illustrating a modification of the mid-section of the device of FIG. I employing U-shaped slotted through holes for attachment of the toe traction apparatus.

And FIG. 10 is a partial detail view illustrating a modification of the mid-section of the device of FIG. 1 employing a combination of through holes and integral pegs for attachment of the toe traction apparatus.

Referring more particularly to FIG. 1, the device consists of a substantially U-shaped member 10 of semi-rigid material. The ends 12 and 14 of themember are spaced apart by a dimensiongenerally corresponding to the width of the patients foot. While this dimension is not particularly critical, the device may be constructed in several sizes so that a small foot need not have a large device appliedthereto. As shown in the drawing, the end portions 12 and 14 may be slanted inwardly to generally conform with the narrowing of a normal foot from the ball portion of the foot toward the upper arch of the foot. Surface discontinuities in the form of transverse ribs 16 are longitudinally spaced along the outer surfaces of each of the ends 12 and 14 to provide anchorage of the ends within a plaster cast.

The curved mid-section of the device includes a curved portion at 18 and a curved portion at 20 separated by a relatively straight portion at 22. This outline shape generally conforms to a normal outline for the front of the patients foot, the alignment of the straight portion 22 being generally parallel to a line which would be tangent to the tips of the patients toes.

Between the curved portion 18 and the inwardly slanted end portion 14 there may be provided a relatively straight side portion 19. Similarly, between the curved portion 20 and the inwardly slanted end portion 12 there may be a relatively straight side portion 21. For reference purposes, a center line 23 is illustrated in the drawing which is parallel to the straight side portions 19 and 21 and equidistant between side portions 19 and 21. It has been found that if the straight portion 22 is inclined or slanted about 23 degrees away from a direction perpendicular to the center line 23, the angle closely approximates that of a tangent to the tips of the toes of a typical patient. This angle corresponds to an angle of approximately 67 with respect'to the center line 23. The portions 12 and 14 are respectively slanted inwardly, preferably with a deviation angle of about l0 from the associated straight portions 19 and 21.

All across the mid-section 18, 20, 22 of the device there are provided surface discontinuity features consisting of transversely arranged ribs 24 for the purpose of anchoring toe traction devices. As illustrated in FIG.

2, these ribs 24 preferably have ends which extend beyond the marginal edges of the main body of the device to enhance the anchoring effect. As illustrated in FIGS. 1 and 2, exclusive of the ribs 16 and 24, the device has a thin rectangular cross section shape.

FIG. 3 illustrates a typical installation of the device of FIGS. 1 and 2 in combination with a foot cast 26, and arranged to protect the exposed toes 28 of the patient. The installation procedure is usually as follows: The cast is constructed in the usual manner. However, after several layers of the plaster and gauze have been applied to the foot, the device 10 is placed in the proper position with the end portions 12 and 14 embracing the sides of the cast enclosed foot. Preferably, the ends 12 and 14 are spaced closer together than the width dimension of the cast enclosed foot so that these ends must be sprung outwardly to position the device over the outside of the cast enclosed foot. This is referred to below as a constricted spacing. Thus, the inward spring force at the ends 12 and 14 of the device assist in initially maintaining the device positioned upon the cast enclosed foot in the desired position. The wrapping of the plaster gauze is then continued so that the wrappings are applied around the ends 12 and 14 of the device, enclosing them in the cast. The ribs 16 serve to provide positive anchorage for the device. Thus, when the plaster hardens, the device becomes a structurally integral part of the cast. The width of the device from the upper to the lower marginal edges is preferably about three-quarters of an inch, equalling or exceeding the usual maximum thickness of the patients toes, so as to preserve and maintain a guarded space which is more or less coextensive with the toes.

FIG. 4 is a detail perspective view illustrating how the device is used as a traction splint when a toe is to be maintained in traction. In this drawing, a skin traction arrangement is illustrated in which there is an attachment to the middle toe by means of pressure sensitive adhesive tape indicated at 30. A rubber band 32 is looped around the end of the device 10 and through its own end loop, preferablyso that it embraces one of the ribs 24, and is thus anchored in position upon the device 10, as shown. The rubber band is then attached to the toe by means of the tape 30. As illustrated in FIG. 4, in order to provide space for the rubber band traction device 32, the device 10 is assembled to the cast in a forward extended position. It is quite apparent that the device 10 can be used to maintain several toes in traction at the same time. As illustrated, there are many more ribs 24than there are toes. This permits the selec tion of a rib which is appropriately aligned for each particular traction problem. While not illustrated in the drawings, the device 10 can also be used for skeletal traction procedures in which the traction rubber band 32 is attached to the toe by means of a pin or a similar device.

The same device 10 can be used for both the left foot and the right foot, matching the unsymmetrical end of the device to the end of the foot by simply turning it over.

Also, when used as a traction splint, and when the small toes are involved, some space may sometimes be saved by turning the device 10 over as it is assembled to the plaster cast so that the curved portion 18 is near the great toe, and the curved portion 20 is on the opposite side adjacent to the small toe. In this manner, the curved portion 18 can be assembled relatively close to the great toe, and the greater protrusion provided by the curved portion 20 is sufficient to provide-space for traction devices to be attached to the small toes.

While the device 10 is designed primarily to fit the foot, and for use with a foot, it can also be used as a traction splint for the hand for maintaining fingers in traction.

The device 10 may be composed of various semirigid materials, and the choice of material is not believed to be critical. However, the materials generally referred to as plastics and composed of synthetic resins, are believed to be particularly desirable for this product. While there are many suitable synthetic resin materials which may be selected, high density polyethylene is believed to be particularly effective and useful because it is economical, tough, resilient, and has a natural color which has an appearance which is compatible with that of a plaster cast.

FIG. 5 is a fragmentary detail view showing an end 12 of the orthopedic device 10 and illustrating an alternative embodiment for the anchoring protrusions. As illustrated in FIG. 5, the protrusions may consist of integral knobs 16A rather than the ribs 16 disclosed in connection with the prior figures. Thus, while the ribs are preferred, the knobs 16A are believed to accomplish the purpose very effectively. It is believed that other surface irregularities and protrusions would also accomplish the purpose effectively.

FIGS. 6 through 10 disclose various alternative arrangements in the surface discontinuities of the curved mid-section (18, 20, 22) for attachment of the traction devices. All of these alternative embodiments involve the use of perforations.

In FIG. 6, the perforations are in the form of edge slots 36. In FIG. 7, the perforations include the edge slots 36 plus alternately spaced edge slots 38 in the opposite edge. As illustrated in the drawings, these edge slot configurations have the virtue that they simplify the attachment of the rubber band 32 so that the rubber band need not be looped back upon itself at the point of attachment to the device as it is in FIG. 4 and FIG. 8.

FIG. 8 illustrates another alternative embodiment in which the surface discontinuities simply consist of round perforations 40 through the device. This has the virtue of simplicity, and maintenance of smooth edges on the device. However, it does require that the rubber band 32 must be threaded through the perforations 40 and looped upon itself to establish a secure connection.

FIG. 9 illustrates an alternative embodiment in which the perforations are in the form of individual U-shape'd slots 42. Here again, the rubber band need not be looped upon itself in order to establish a secure connection.

FIG. 10 illustrates still another configuration employing a combination of through holes 44 and 46 together with integrally fonned pins 48. As illustrated, this arrangement again avoids the need for looping the rubber band 32 upon itself for attachment to the orthopedic device 10.

While this invention has been shown and described in connection with particular preferred embodiments, various alterations and modifications will occur to those skilled in the art. Accordingly, the following claims are intended to define the valid scope of this invention over the prior art, and to cover all changes and modifications falling within the true spirit and valid scope of this invention.

I claim:

1. An orthopedic device for combination with a plaster cast of the type applied to the foot of a fracture patient and leaving the toes uncovered,

said orthopedic device comprising a substantially U- shaped member of semi-rigid material,

said member being adapted to be attached at the ends thereof to the opposite sides of the plaster cast and extending around the front of the cast to protect the patients toes,

said member including surface discontinuities longitudinally spaced along each end thereof to provide for anchorage of said ends within the plaster cast,

the end portions of said member being slanted inwardly and having a constricted spacing between the ends thereof to engage the sides of the foot of the patient with a spring force during the construction of the plaster cast,

said U-shaped member having a generally curved midsection intended to surround the front of the patients foot,

said curved midsection including two curved portions and a straight portion intermediate to said curved portions,

said straight portion being slanted at an angle of about 67 to the center line of said device to thereby approximate a direction parallel to a line tangent to the tips of the toes of a typical patient when the device is assembled with a cast on the foot.

2. A device as claimed in claim 1 wherein said member has a substantially uniform thickness from the inside surface to the outside surface thereof and a substantially uniform width between the upper and lower marginal edges thereof.

3. A device as claimed in claim 2 wherein the dimension of said thickness is substantially less than the dimension of said width.

4. A device claimed in claim 1 wherein said surface discontinuities comprise protrusions from at least one surface of said member.

5. A device as claimed in claim 4 wherein said protrusions are provided upon an outer surface of said member.

6. A device as claimed in claim 5 wherein said protrusions are comprised of ribs transversely arranged with respect to the longitudinal dimension of said member and regularly spaced along said longitudinal dimension.

7. A device as claimed in claim 5 wherein said protrusions comprise a series of knobs arranged in a, regular pattern along the longitudinal dimension of said member.

8. A device as claimed in claim 1 wherein there is included a separate straight side portion between each of said curved portions and the associatedslanted end portion,

each of said straight side portions being substantially parallel to the center line of the device.

9. An orthopedic device as claimed in claim 1 wherein the mid-portions of said U-shaped member in the vicinity of the curves therein are provided with surface discontinuity features for anchoring toe traction devices thereto so that said device is operable as a traction splint.

10. A device as claimed in claim 9 wherein said surface discontinuity features are regularly spaced along the longitudinal dimension of said U- shaped member.

11. A device as claimed in'claim 9 wherein I said surface discontinuity features are comprised of ribs transversely arranged along the exterior sur face of said U-shaped member.

12. A device as claimedin claim 11 wherein said transverse ribs extend beyond the upper and lower marginal edges of the body of said U-shaped member to enhance the anchoring effect of said ribs.

13. A device as claimed in claim 9 wherein said surface discontinuity features comprise openings extending through the body of said U-shaped member.

14. A device as claimed in claim 13 wherein said openings comprise a series of slots in the edges of said U-shaped member.

15. A device as claimedin claim 14 wherein said edge slots are alternately spaced in opposite edges of said U-shaped member.

l6.'A device as claimed in claim 13 wherein said openings comprise through holes in said U- shaped member.

17. A device as claimed in claim 16 wherein said holes consist of slotted U-shaped holes at regularly spaced longitudinal positions in said U-shaped member.

18. A device as claimed in claim 16 wherein said surface discontinuity features for anchoring a toe traction device include both through holes and integral pegs.

19. A device as claimed in claim 1 wherein the semi-rigid material of said U-shaped member consists essentially of a synthetic resin.

20. A device as claimed in claim 19 wherein said synthetic resin is a high density polyethylene.

21. An improved plaster cast and toe traction splint for the foot of a fracture patient comprising an open-toed cast structure including layers of plaster impregnated gauze wrappings,

said cast including in combination a substantially U- shaped member of semi-rigid material having the ends thereof anchored in the sides of the plaster cast and having the curved midsection thereof extending around the front of the plaster cast to protect the toes of the patient,

said curved midsection including two curved portions and-a straight portion intermediate to said curved portions,

said straight portion being slanted at an angle of about 67 to the center line of said U-shaped member to thereby approximate a direction parallel to a line tangent to the tips of the toes of a typical patient,

said curved midsection of said U-shaped member having a plurality of spaced surface discontinuity features for anchoring toe traction devices thereto. 

1. An orthopedic device for combination with a plaster cast of the type applied to the foot of a fracture patient and leaving the toes uncovered, said orthopedic device comprising a substantially U-shaped member of semi-rigid material, said member being adapted to be attached at the ends thereof to the opposite sides of the plaster cast and extending around the front of the cast to protect the patient''s toes, said member including surface discontinuities longitudinally spaced along each end thereof to provide for anchorage of said ends within the plaster cast, the end portions of said member being slanted inwardly and having a constricted spacing between the ends thereof to engage the sides of the foot of the patient with a spring force during the construction of the plaster cast, said U-shaped member having a generally curved midsection intended to surround the front of the patient''s foot, said curved midsection including two curved portions and a straight portion intermediate to said curved portions, said straight portion being slanted at an angle of about 67* to the center line of said device to thereby approximate a direction parallel to a line tangent to the tips of the toes of a typical patient when the device is assemBled with a cast on the foot.
 2. A device as claimed in claim 1 wherein said member has a substantially uniform thickness from the inside surface to the outside surface thereof and a substantially uniform width between the upper and lower marginal edges thereof.
 3. A device as claimed in claim 2 wherein the dimension of said thickness is substantially less than the dimension of said width.
 4. A device as claimed in claim 1 wherein said surface discontinuities comprise protrusions from at least one surface of said member.
 5. A device as claimed in claim 4 wherein said protrusions are provided upon an outer surface of said member.
 6. A device as claimed in claim 5 wherein said protrusions are comprised of ribs transversely arranged with respect to the longitudinal dimension of said member and regularly spaced along said longitudinal dimension.
 7. A device as claimed in claim 5 wherein said protrusions comprise a series of knobs arranged in a regular pattern along the longitudinal dimension of said member.
 8. A device as claimed in claim 1 wherein there is included a separate straight side portion between each of said curved portions and the associated slanted end portion, each of said straight side portions being substantially parallel to the center line of the device.
 9. An orthopedic device as claimed in claim 1 wherein the mid-portions of said U-shaped member in the vicinity of the curves therein are provided with surface discontinuity features for anchoring toe traction devices thereto so that said device is operable as a traction splint.
 10. A device as claimed in claim 9 wherein said surface discontinuity features are regularly spaced along the longitudinal dimension of said U-shaped member.
 11. A device as claimed in claim 9 wherein said surface discontinuity features are comprised of ribs transversely arranged along the exterior surface of said U-shaped member.
 12. A device as claimed in claim 11 wherein said transverse ribs extend beyond the upper and lower marginal edges of the body of said U-shaped member to enhance the anchoring effect of said ribs.
 13. A device as claimed in claim 9 wherein said surface discontinuity features comprise openings extending through the body of said U-shaped member.
 14. A device as claimed in claim 13 wherein said openings comprise a series of slots in the edges of said U-shaped member.
 15. A device as claimed in claim 14 wherein said edge slots are alternately spaced in opposite edges of said U-shaped member.
 16. A device as claimed in claim 13 wherein said openings comprise through holes in said U-shaped member.
 17. A device as claimed in claim 16 wherein said holes consist of slotted U-shaped holes at regularly spaced longitudinal positions in said U-shaped member.
 18. A device as claimed in claim 16 wherein said surface discontinuity features for anchoring a toe traction device include both through holes and integral pegs.
 19. A device as claimed in claim 1 wherein the semi-rigid material of said U-shaped member consists essentially of a synthetic resin.
 20. A device as claimed in claim 19 wherein said synthetic resin is a high density polyethylene.
 21. An improved plaster cast and toe traction splint for the foot of a fracture patient comprising an open-toed cast structure including layers of plaster impregnated gauze wrappings, said cast including in combination a substantially U-shaped member of semi-rigid material having the ends thereof anchored in the sides of the plaster cast and having the curved midsection thereof extending around the front of the plaster cast to protect the toes of the patient, said curved midsection including two curved portions and a straight portion intermediate to said curved portions, said straight portion being slanted at an angle of about 67* to the center line of said U-shaped Member to thereby approximate a direction parallel to a line tangent to the tips of the toes of a typical patient, said curved midsection of said U-shaped member having a plurality of spaced surface discontinuity features for anchoring toe traction devices thereto. 